Most children who have a sibling die due to a pregnancy loss or stillbirth, or in the first few months of life, will experience a grief reaction.  However, often times, their grief is overlooked or discounted. Parents may be so overwhelmed by their own grief that they are unable to assist their children with their issues.

Parents often ask me “Will my child be negatively affected by the death of their baby sibling?”  I have to say the answer to this question is, “Usually not, if the child’s grief is acknowledged.” In this article, I hope to provide some direction in ways to assist little people with their big hurts and ways to validate their feelings.

In Helping Children Cope with the Unexplained Death of Infant, the author, Dr. Charles Corr, outlines four basic psychological tasks that comfort grieving youngsters. These include:  Understanding what has happened, identifying and validating their feelings, commemorating the life of the sibling(s) who died, and learning to live and love again.1

In the following paragraphs, I will address each of these tasks and provide insight and direction from my own experiences. In assisting with the difficult journey of grieving, one should note that a child’s personality, past life experiences, developmental stage, and past reactions to loss will affect his/her reaction to the death of a sibling.

Understanding What Has Happened

Very young children, ages two and under, do not fully understand what has happened, but they are aware of a change in their parent’s behavior.  Children sense that their lives have changed dramatically, and they may become irritable or clingy. Sometimes parents may not have the energy to meet the many emotional and physical demands of their little ones during the demands of their own intense grief. It is important to try to maintain a normal routine even if it requires the assistance of family and friends with the child’s care.

Preschool children need to have things explained in very concrete terms. We need to be careful with our words; children become confused with statements that are not literally clear, for instance things such as “the baby is sleeping with God.” This statement may cause them to be fearful of sleep and of God.  Also, children of this age do not understand the finality of death and think heaven is a place one can visit temporarily.  Parents may become frustrated as children have repeated questions.  Often, simple answers will suffice as children do not want detailed explanations. As the child matures, he/she will have a better concept of death.

School-age children are often frightened by death. They may have fears of sleeping alone or being apart from their family. They may need extra reassurances and more time with you.  Also, children of this age are very curious. Of course, this means they ask many questions and want more detailed explanations. All questions need to be answered and if we as parents do not respond to these questions, their peers will. Other children’s explanations may confuse and upset them even more.

Identifying and Validating Feelings

Parents have shared with me their concern about their preschooler because he or she is sad one minute and happy the next. Preschoolers grieve in spurts and the intensity is not as great as that of an older child. Often, children of this age will act out their feelings through their play. This is very therapeutic and is a way for them to positively release their feelings. Like adults, children respond to grief in many different ways. They may act out their anger by being destructive. It is important to acknowledge this anger and frustration so they can move past it. It can be helpful for them to have a punching bag or pillow to release those feelings. It is also important to have conversations about the loss your family has experienced and how your child has responded to the death with the child’s teachers, coaches, scout masters, and other caregivers. It is helpful to also give these individuals some bereavement literature on ways to help children with the death of a baby.

Commemorating the Life of the Sibling(s) Who Died

A large number of people in our society believe children should not be exposed to death. Parents often are not sure if they should include their child/ren at the time of loss, at the funeral or in the commemorating in the years to come. Parents know  their children better than anyone so these decisions are very personal and what is right for one many not feel right for another.

The parents of children who experience early pregnancy loss may find it more difficult to commemorate this life as often the only tangible evidence they have is an ultrasound picture.  Some commemorative ideas that families experiencing early losses have used are organizing a memorial service at their church, participating in a quarterly group burial service, or having a private intimate service with their family. Others have planted a tree or designed a garden.  Some families find connecting to a specific object such as a teddy bear or a piece of jewelry for themselves and the children is meaningful.

When there is a funeral and a viewing of the baby, sometimes parents are not sure about how to involve the children. The child may or may not have seen the baby at the hospital.  Talking to them about the choice and informing them what to expect at the viewing and the funeral helps the child and parent make a decision.  Some children may come to just the viewing and not the funeral and some want to be a part of the entire ritual. It is always helpful to have someone there to support the child/ren in case the parents need to leave.

Most children love to draw, color or write poems or letters.  Giving them the opportunity to create a special picture or letter to place in the casket may bring them comfort. Children loved to have their own keepsakes and may find having a special stuffed animal, piece of jewelry, baby’s handprints or footprints, and/or baby’s picture quite helpful. This connection to the baby may be a treasure for years to come.

Annual memorial services or walks held by support groups are a wonderful way to involve children. Sometimes at the time of the loss, the children may not have been a part of the initial ritual. Group memorials are opportunities to share with other bereaved families and a means to positively remember their baby.  This may be the first time a child has had an opportunity to remember their sibling.  At memorial services, children as well as parents can participate by writing a message on their balloon and releasing it, placing a holiday ornament on a tree or lighting their own candle.

Lastly, family rituals such as placing flowers on the grave, releasing balloons, lighting candles, planting special plants etc in honor of the baby on birthdays, anniversaries, and other difficult days can be helpful. Some families have found planning something special with their children during those remembrance days such as an outing to movie, dinner or even a day trip is a positive means of healing with their family.

Learning to Live and Love Again

Children will not forget their experience of having a baby brother or sister die.  However, they will be able to lead productive, wonderful lives if given permission to openly mourn and have their feelings validated. They need support and understanding of their grief in order to be able to integrate this loss into their lives.  As they move through each developmental stage, new questions may be asked, and they may need more in-depth answers.  This does not mean they are regressing, but rather they are maturing and need to clarify some issues in their hearts and minds. Some children adjust to this loss easier and others need extra help with a support group or therapist.

In closing, your children are often your greatest source of comfort. Their openness and non-judgmental attitudes may allow you to express yourself and give permission to talk about your baby.  Bereaved children have learned about grief at often a very young age. However, often with a grief experience, growth does occur and gifts such as compassion and kindness follow. These may be the best of many gifts their brother or sister has left them.

1Charles Corr, PhD., Building Blocks:  Helping Children Cope with the Sudden and Unexplained Death of an Infant, (SIDS Resources, Inc. Missouri Department of Health, Division of Administration, P.O. Box 570, Jefferson City, MO)

This first appeared in Sharing Newsletter: Volume 18, Issue 1; National Share Office, www.nationalshare.org

Cathi Lammert, R.N., is Executive Director of the National Office of SHARE Pregnancy and Infant Loss Support, Inc. www.nationalshare.org.  As a bereaved parent, Cathi combines her personal experience with her education and professional background as an obstetrical nurse. Her son, Christopher Michael lived just 4 days and died due to Hydrops Fetalis, a complication of Rh sensitization.  Cathi was a guest on the radio show Healing the Grieving Heart with Dr. Gloria & Dr. Heidi Horsley, to discuss Finding Help and Hope After Pregnancy Loss. To hear Cathi being interviewed on this show, click on the following link:  www.voiceamericapd.com/health/010157/horsley011509.mp3 For more information, you can e-mail Cathi at:  clammert@nationalshare.org

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Cathi Lammert

Cathi Lammert, R.N.- Executive Director of the National Office of SHARE Pregnancy and Infant Loss Support, Inc. As a bereaved parent, Cathi combines her personal experience with her education and professional background as an obstetrical nurse. Her son, Christopher Michael lived just 4 days and died due to Hydrops Fetalis, a complication of Rh sensitization. She and her husband Chuck have been involved with Share since 1983, shortly after Christopher's death. Their work began as Share group facilitators for the first group in St. Louis. Cathi became the executive director of National Share in 1992. Her duties include managing the national office, conducting workshops for professionals, clergy, bereaved parents and their families, writing articles/material on perinatal bereavement issues, supporting 80 Share support groups, serving as a resource for professionals and the media and advocating for bereaved parent's rights. The part of her job that touches her most is time spent hands on with bereaved families and their precious babies. She feels the bereaved parents have been her greatest teachers. Some of the highlights of her past few years are: * Brought the Angel of Hope Monument to Ben Rau Garden in Blanchette Park and expanding the site with Cardinal Care walkway * Co-author of Angelic Presence * First President of the National Pregnancy Loss and Infant Death Alliance PLIDA plida.org * Developed the Share Companion Program allowing volunteers to support families at the time of loss * Interviewed for Lutheran Ministries program, a nationally syndicated program on pregnancy loss and infertility * Participated in the Stillbirth Research Roundtable supported by National Institute of Health * Acted as a consultant and advocate for the passage of MO House Bill 1136 supporting the need for a birth resulting in stillbirth certificate and for proper disposition for early pregnancy losses * Moderated nationwide telecast on loss issues with the national office of Head Start * Executive producer with Stepstone Productions for national video series Grieving in the NICU Mending Broken Hearts When a Baby Dies. Cathi was a guest on the radio show Healing the Grieving Heart with Dr. Gloria & Dr. Heidi Horsley, to discuss Finding Help and Hope After Pregnancy Loss. To hear Cathi being interviewed on this show, go to the following link: https://www.voiceamerica.com/episode/35689/finding-help-and-hope-after-pregnancy-loss-and-finding-help-and-hope-after

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